Rivaroxaban versus low molecular weight heparin in prevention of venous thromboembolism in patients undergoing hip or knee arthroplasty

Abstract

Objective To evaluate the efficacy and safety of Rivaroxaban versus low molecular weight heparin (LMWH) in prevention of venous thromboembolism (VTE) after total hip or knee arthroplasty.Methods From August, 2009 to July, 2010, 84 patients were recruited in this study. Under randomization, 48 were assigned into the observation group of Rivaroxaban and 36 into the control group of LMWH.The observation group had 13 males and 35 females, including 25 cases of total hip arthroplasty (THA) and 23 cases of total knee arthroplasty (TKA). The control group had 10 males and 26 females, including 16 cases of THA and 20 cases of TKA. Oral Rivaroxaban (10 mg once per day) was administered for THA patients from day 1 to 35 postoperatively and for TKA patients from days 1 to 14 postoperatively. Hypodermic injection of LMWH (0. 4mL once per day) was administered for THA patients from days 1 to 35 postoperatively and for TKA patients from days 1 to 14 postoperatively. Results All the patients were followed up for 3 months.The VTE rate was 20. 8% (10/48) in the observation group, and 25.0% (9/36) in the control group. The difference between the 2 groups was insignificant (χ2 =0. 204, P =0. 651). There was no significant difference either in intraoperative postoperative bleeding between the 2 groups (P ＞ 0. 05). No symptoms of pulmonary embolism were observed in either group. Conclusions The clinical efficacy and safety of Rivaroxaban is comparable to LMWH in reducing the incidence of VTE after THA or TKA. Rivaroxaban is associated with low risks of hematomas, delayed wound healing, and postoperative infection. Key words: Venous thrombosis; Arthroplasty, replacement; Heparin, low molecular weight; Rivaroxaban